Do physician outcome judgments and judgment biases contribute to inappropriate use of treatments? Study protocol.

Background: There are many examples of physicians using treatments inappropriately, despite clear evidence about the circumstances under which the benefits of such treatments outweigh their harms. When such over- or under- use of treatments occurs for common diseases, the burden to the healthcare system and risks to patients can be substantial. We propose that a major contributor to inappropriate treatment may be how clinicians judge the likelihood of important treatment outcomes, and how these judgments influence their treatment decisions.

Age-specific fluoride exposure in drinking water and osteosarcoma (United States).

Objective: We explored age-specific and gender-specific effects of fluoride level in drinking water and the incidence of osteosarcoma.

Methods: We used data from a matched case-control study conducted through 11 hospitals in the United States that included a complete residential history for each patient and type of drinking water (public, private well, bottled) used at each address. Our analysis was limited to cases less than 20 years old.

Problems in exposure assessment of fluoride in drinking water.

Objectives: We developed a source documentation approach that identified fluoride content of drinking water at the state or local level to estimate fluoride concentrations from public water systems. We then compared estimates from this approach with estimates obtained from a single source, the 1992 Centers for Disease Control and Prevention (CDC) Fluoridation Census.

Methods: We used residential histories from a case-control study.